Benzekri Noelle A, Sambou Jacques F, Diaw Binetou, Sall El Hadji Ibrahima, Sall Fatima, Niang Alassane, Ba Selly, Guèye Ndèye Fatou Ngom, Diallo Mouhamadou Baïla, Hawes Stephen E, Seydi Moussa, Gottlieb Geoffrey S
a Department of Medicine , University of Washington , Seattle , WA , USA.
b Le Pavillon de Traitement Ambulatoire , Centre de Santé de Ziguinchor , Ziguinchor , Sénégal.
AIDS Care. 2017 Dec;29(12):1510-1516. doi: 10.1080/09540121.2017.1338652. Epub 2017 Jun 14.
An understanding of the factors contributing to food insecurity and malnutrition among people living with HIV (PLHIV) in Senegal is urgently needed in order to develop effective interventions. The goals of this study were to identify differences in the dimensions of food security among PLHIV in Dakar versus Ziguinchor, Senegal, to determine which of these dimensions are most predictive of severe food insecurity, and to identify factors associated with malnutrition. We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review. Interviews were conducted with ninety-five food insecure, HIV-infected subjects. Daily household income and daily food expenditure per household member were the strongest predictors of severe food insecurity. The practice of agriculture, livestock ownership, nutritional status, and HIV outcomes were not predictive of severe food insecurity. CD4 count <350/mm was the strongest predictor of malnutrition. Severe food insecurity, daily household income, daily food expenditure per household member, dietary diversity score, skipping meals, the practice of agriculture, livestock ownership, ART status, and adherence were not predictive of malnutrition. This is the first study to analyze the dimensions of food security among PLHIV in Senegal. We discovered important differences in food access, availability, stability, and utilization in Dakar versus Ziguinchor. We found that economic access was the strongest predictor of severe food insecurity and poorly controlled HIV was the strongest predictor of malnutrition. Our findings suggest that the interventions needed to address food insecurity differ from those necessary to target malnutrition, and that effective interventions may differ in Dakar versus Ziguinchor. Furthermore, this study highlights a need for a greater understanding of the relationship between HIV and malnutrition among individuals receiving ART in resource-limited settings.
为制定有效的干预措施，迫切需要了解导致塞内加尔艾滋病毒感染者（PLHIV）粮食不安全和营养不良的因素。本研究的目的是确定塞内加尔达喀尔与济金绍尔的艾滋病毒感染者在粮食安全维度上的差异，确定哪些维度最能预测严重粮食不安全，并确定与营养不良相关的因素。我们在塞内加尔达喀尔和济金绍尔的门诊诊所进行了一项横断面研究。通过参与者访谈、人体测量、家庭粮食不安全获取量表、个人饮食多样性量表和病历审查收集数据。对95名粮食不安全的艾滋病毒感染受试者进行了访谈。家庭日收入和家庭成员每日食品支出是严重粮食不安全的最强预测因素。农业生产、牲畜拥有情况、营养状况和艾滋病毒治疗结果不能预测严重粮食不安全。CD4细胞计数<350/mm是营养不良的最强预测因素。严重粮食不安全、家庭日收入、家庭成员每日食品支出、饮食多样性得分、不吃饭、农业生产、牲畜拥有情况、抗逆转录病毒治疗状态和依从性不能预测营养不良。这是第一项分析塞内加尔艾滋病毒感染者粮食安全维度的研究。我们发现达喀尔与济金绍尔在粮食获取、供应、稳定性和利用方面存在重要差异。我们发现经济获取是严重粮食不安全的最强预测因素，而艾滋病毒控制不佳是营养不良的最强预测因素。我们的研究结果表明，解决粮食不安全问题所需的干预措施与针对营养不良问题所需的措施不同，而且达喀尔与济金绍尔的有效干预措施可能也不同。此外，本研究强调需要更深入了解资源有限环境中接受抗逆转录病毒治疗的个体中艾滋病毒与营养不良之间的关系。
